Exploring Community Public Health in Southland Argentina

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September 11, 2015

Whittier College, Study Abroad, Argentinaby Lightmary Flores '17

As a first-generation college student, the idea of studying abroad seemed out of reach. But, thanks to the fellowships and study abroad resources available at Whittier, I applied and was awarded a Gilman Study Abroad International Scholarship, which allowed me to travel to Argentina and Uruguay this summer.  As a Whittier Scholars Program major, I was thrilled to be part of the Council International Educational Exchange’s (CIEE) Community Public Health program that would took place in Buenos Aires, the “Paris of South America.” I learned first-hand about the public health system and health policy of Argentina.

As a first-generation college student, the idea of studying abroad seemed out of reach until I found out that I was awarded a Benjamin A. Gilman International Scholarship, which allowed me to travel to Argentina this summer. As a Whittier Scholars Program major, I was thrilled to be part of the Council International Educational Exchange’s (CIEE) Community Public Health program in Buenos Aires, the “Paris of South America.” I learned first-hand about the public health system and health policy of Argentina.

When I first arrived, I was struck by the green pastures that went on for miles and 1960s charter buses with people shouting and holding out signs with the message of “Viva la Patria.” It turned out that I had arrived to Argentina on a national holiday. May 25 marked the 205th anniversary of their Independence from Spain.

That night, I savored my first dulce de leche-flavored gelato and admired the neo-classical architecture of the tall buildings as I walked toward the heart of the city with all my program classmates, who came from different states. Although I could not see President Cristina Kirchner on stage as she gave her public address in the Plaza de Mayo, a public space nearby the Presidential Palace. Amongst thousands and thousands of people, I heard her words, I felt the excitement and I knew that my experience in Argentina had just begun.

I remained restless during my first nights in Buenos Aires, “the city that never sleeps,” as the sound of the busy streets of Rivadavia, romantic boleros and traditional tango tunes flowed into my balcony window of the chic multistory apartment where I resided. Every evening in a dining room decorated with colorful vitraux windows and dark wooden furniture, I shared with my host family, La Familia Krasñansky, my own Mexican culture and my artesian walks down La Boca and Palermo, where friendly locals greeted each other with a kiss and yelled from across the street “Oye Che,” a form of saying “hey buddy,” with their fingers as if holding a pinch of salt. 

I soon learned that personal space was nonexistent as I boarded Buenos Aires’ underground metro, known as the Subte. I was usually accompanied with a beatboxer or violinist’s solemn melody each morning as I traveled to Flacso, my local higher education institution. My program’s curriculum included lectures from different local doctors, health officials and professors, who focused on topics such as the social determinants of health, Argentina’s primary healthcare system and the comparison of sanitary conditions between Argentina, U.S. and Canada.

During these lectures, my classmates and I were surprised to learn that any foreign citizen who steps foot onto Argentinian soil has a right to healthcare and free education. “It’s a form of socialism,” as some of my American colleagues called it.

I also had the opportunity to visit hospitals to see first-hand the state of neonatal care and public health in Argentina. The sight of newborn babies weighing under 500g dependent on neonatal intensive care born to adolescents as young as 13 and women of low socioeconomic status without health insurance spoke about the importance of understanding the social determinants of health and the necessity to work further at the first level of care.

According to one of the neonatal surgeons at a hospital in Buenos Aires, they have some of the best doctors and everyone has access to primary care, but there is still a lot of inequity and a high infant mortality rate.

Our group excursion toward central Argentina in Merlo, San Luis allowed me to discover the social and sanitary health conditions of more rural regions by speaking with health care workers, visiting public schools, visiting a primary health care center and taking the opportunity to meet a midwife, who was 103 years old but whose spirit remained young.

Our hike along Camino del Sol allowed us to learn the history behind the plains of Las Sierras de Comechingones and how the Merlo naives coined the concept of the “gaucho.” As we visited Merlo, we learned of the traditional uses of medicinal plants, crossed rivers, explored abandoned mines and overlooked the mountains to see small towns decorated with red rooftops hidden within the evergreen forests.

The image of a Paraguayan woman singing in her native Guarani language to her newborn as she waited to receive her order of fortified milk from her pediatrician as part of the National Maternal and Child Plan, will never escape my memory. In Concepción del Uruguay, I gained a more in-depth look at local care at the municipal level, the administration of primary care in the public sector and maternal-infant health.

As part of my fieldwork, I worked as part of a health management team. I manually recorded the diagnoses of 33 mothers who had given birth at the Hospital Urquiza onto medical documents, known as Prenatal Clinic Histories containing all of the patients’ data. Using georeferencing methods, we were able to find greater rates of infants with low birth rate living in vulnerable “barrios,” such as Bajada Grande and La Concepción. Through analysis, I was able to find significant correlations between different factors among the different mothers and low birth weight. Some of these factors included: level of education, marital status and age of gestation.

As I explored the green meadows of Entre Rios, I sipped the bitter taste of “mate,” a traditional and very popular herbal tea. I saw moments of community empowerment and health promotion as patients awaited to be attended to at the distinct Primary Health Care Centers (CAPS) and as public health officials held community vaccine drives and educational talks about sanitation and sexual health in the Community Integrating Center (CIC).

The final week upon our return to Buenos Aires, I listened attentively as classmates presented their final research projects on topics ranging from environmental quality, health education and social development, healthcare in rural setting, health promotion and adolescents health at their distinct research sites.

“Un aplauso para el asador [a round of applause for the griller],” Study Center Director of CIEE Buenos Aires Andrea Rizzotti shouted as we all cheered and applauded the cook after we enjoyed our last asado glazed with special chimichurri sauce with all who had become like a family, including my host family, classmates and CIEE staff and professors. I contemplated my two months in Argentina which flew by in a dash, as we were graced with the musical stylings of a musical trio of Argentinians on the accordion and flute who sang the final song:

No llores por mí, Argentina

[Don’t cry for me, Argentina]

Mi alma está contigo 

[My soul is with you]

Mi vida entera te la dedico

[My whole life through I dedicate             

to you]

Mas no te alejes, te necesito…

[But do not go away, I need you]

 

This article was originally published in the Quaker Campus